Background and objectives: There is wide variation in clinical presentations of sarcoidosis across different ethnic groups and geographical areas. Methods: Ninety-six patients with histopathologically proven sarcoidosis from Punjab were studied during the period January 2012 to January 2016 at the teaching hospital attached to our medical college. Results: Their mean age was 46.6±10.6 years; there were 51 (53.1%) females. All the patients were symptomatic at the time of presentation; 64.6% presented with predominantly respiratory symptoms while 35.4% had prominent extra-pulmonary symptoms. The various extra-pulmonary features presenting as the initial manifestations of sarcoidosis in the present study included prolonged pyrexia (13.5%); acute kidney injury (5.2%); neurological (5.2%); salivary gland (5.2%) and ocular (3.1%) involvement. About 10% of our patients had presented with life threatening manifestations as the sole presentation of the disease. The chest radiograph at presentation revealed stage 0 in 5.2%; stage 1 in 51.1%; stage 2 in 26% and stage 3 in 17.7% patients. Conclusions: In our study female preponderance was noted and the disease peaked during the late fourth decade of life. All the patients were symptomatic at the time of presentation and extra-pulmonary manifestations were the presenting feature in around one-third of the patients. Prolonged pyrexia, anicteric cholestasis, salivary gland involvement and AKI were uncommon, but important salient clinical manifestations in patients presenting with sarcoidosis from Punjab.